While it is unusual to have a bilirubin of 9 mg/dl in a breastfed infant at
6 weeks of age, it is not unknown and it certainly falls within what has
been seen with Breastmilk Jaundice and is probably quite normal.  It is
implied in the query that tests have been done to rule out obstructive
jaundice and liver disease.  This is very important in all cases of
prolonged jaundice and can be done quite simply by obtaining a
"direct-reacting" serum bilirubin.  Also, on-going hemolysis should be ruled
out by obtaining a hemoglobin concentration or hematocrit.  Finally, it is
important to rule out hypothyroidism; this can be done by checking the
newborn metabolic screen results which in most states includes a test for
hypothyroidism.  If all of these are normal and the infant is thriving there
is no need to do anything further - except continue the breastfeeding.
There is certainly no reason to even consider interruption of breastfeeding.
                                        Larry Gartner
Lawrence M. Gartner, M.D.
Professor of Pediatrics and Obstetrics/Gynecology
The University of Chicago
E-mail: [log in to unmask]
Phone: (312) 702-0389
FAX: (312) 702-4523